Employment

Position Applied for:

Date of Application:

Last Name

First Name

Middle Name

Mailing Address

Telephone Number

Email

The best time to contact you at home is:

If you are under 18 years of age, can you provide required proof of eligibility to work?

Yes

No

Have you ever filled an application with us before?

Yes

No

If yes, give date:

Do any friends or relatives work at Shinnecock?

Yes

No

If yes, give name, relationship and location:

Are you currently employed?

May we contact your present employer?

Yes

No

Are you prevented from lawfully becoming employed in the USA because of visa or immigration status? Proof of citizenship or immigration status will be required upon employment.

Yes

No

Date available to work:

Are you available to work:

Full Time

Part Time

Education - High School

Name and Address

Course of Study

Diploma/Degree

Education - Undergraduate College

Name and Address

Course of Study

Diploma/Degree

Education - Graduate/Professional

Name and Address

Course of Study

Diploma/Degree

Education - Other (Specify)

Name and Address

Course of Study

Diploma/Degree

Work Experience 1

Employer

Address

Telephone Number

Job Title

Supervisor

May be contact?

Yes

No

Reason for Leaving

From

To

Work Performed:

Work Experience 2

Employer

Address

Telephone Number

Job Title

Supervisor

May be contact?

Yes

No

Reason for Leaving

From

To

Work Performed:

Work Experience 3

Employer

Address

Telephone Number

Supervisor

May be contact?

Yes

No

Job Title

Reason for Leaving

From

To

Work Performed:

Describe any job related or specialized training:

Describe any specialized skills:

Professional Reference 1

Reference Name

Reference Phone Number

Reference's Relationship to You

Reference's Occupation

Professional Reference 2

Reference Name

Reference Phone Number

Reference's Relationship to You

Reference's Occupation

Professional Reference 3

Reference Name

Reference Phone Number

Reference's Relationship to You

Reference's Occupation

Employment Application